{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:33:21Z","timestamp":1790876001122,"version":"4.1.0"},"reference-count":258,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Traditionally studied in isolation, the oral and gut microbiota are now being recognized as interconnected through anatomical and physiological pathways forming a dynamic \u201coral\u2013gut microbiota axis\u201d. Both oral and gut microbiota undergo changes with aging, characterized by a decline in microbial diversity and a shift toward potentially harmful species. The aim of this review is, therefore, to provide an overview of oral\u2013gut communications in mediating frailty and sarcopenia. PubMed, EMBASE and Scopus databases were searched for relevant articles. We limited our search to manuscripts published in the English language. Interactions between oral and gut microbiota occur mainly through three pathways namely the enteral, the bloodstream and the fecal-oral routes. Alterations in the oral\u2013gut microbiota axis contribute to chronic low-grade inflammation (i.e., \u201cinflamm-ageing\u201d) and mitochondrial dysfunction, key mechanisms underlying frailty and sarcopenia. Microbial metabolites, such as short-chain fatty acids and modified bile acids, appear to play an emerging role in influencing microbial homeostasis and muscle metabolism. Furthermore, poor oral health associated with microbial dysbiosis may contribute to altered eating patterns that negatively impact gut microbiota eubiosis, further exacerbating muscle decline and the degree of frailty. Strategies aimed at modulating the microbiota, such as healthy dietary patterns with reduced consumption of ultra-processed foods, refined carbohydrates and alcohol, ensuring an adequate protein intake combined with physical exercise, as well as supplementation with prebiotics, probiotics, and omega-3 polyunsaturated fatty acids, are increasingly recognized as promising interventions to improve both oral and gut microbiota health, with beneficial effects on frailty and sarcopenia. A better understanding of the oral\u2013gut microbiota axis offers promising insights into nutritional interventions and therapeutic strategies for the age-related muscle decline, frailty and systemic health maintenance.<\/jats:p>","DOI":"10.3390\/nu17152408","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T16:04:51Z","timestamp":1753286691000},"page":"2408","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Oral\u2013Gut Microbiota Axis as a Mediator of Frailty and Sarcopenia"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4910-7373","authenticated-orcid":false,"given":"Domenico","family":"Azzolino","sequence":"first","affiliation":[{"name":"Geriatric Unit, Medical Department, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5673-7914","authenticated-orcid":false,"given":"Margherita","family":"Carnevale-Schianca","sequence":"additional","affiliation":[{"name":"Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4176-3939","authenticated-orcid":false,"given":"Lucrezia","family":"Bottalico","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Section of Microbiology and Virology, School of Medicine, University Hospital of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0806-4327","authenticated-orcid":false,"given":"Marica","family":"Colella","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Section of Microbiology and Virology, School of Medicine, University Hospital of Bari, 70124 Bari, Italy"},{"name":"Doctoral School, eCampus University, 22060 Novedrate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8602-9986","authenticated-orcid":false,"given":"Alessia","family":"Felicetti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2720-1473","authenticated-orcid":false,"given":"Simone","family":"Perna","sequence":"additional","affiliation":[{"name":"Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria, 2, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3596-104X","authenticated-orcid":false,"given":"Leonardo","family":"Terranova","sequence":"additional","affiliation":[{"name":"Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8133-3306","authenticated-orcid":false,"given":"Franklin","family":"Garcia-Godoy","sequence":"additional","affiliation":[{"name":"Bioscience Research Center, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA"},{"name":"The Forsyth Institute, Cambridge, MA 02142, USA"},{"name":"Department of Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8336-4851","authenticated-orcid":false,"given":"Mariangela","family":"Rondanelli","sequence":"additional","affiliation":[{"name":"Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy"},{"name":"Endocrinology and Nutrition Unit, Azienda di Servizi Alla Persona \u2018\u2019Istituto Santa Margherita\u2019\u2019, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Carmine","family":"Passarelli","sequence":"additional","affiliation":[{"name":"Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS, University Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2029-5120","authenticated-orcid":false,"given":"Tiziano","family":"Lucchi","sequence":"additional","affiliation":[{"name":"Geriatric Unit, Medical Department, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7026198","DOI":"10.1155\/2018\/7026198","article-title":"Gut Dysbiosis and Muscle Aging: Searching for Novel Targets against Sarcopenia","volume":"2018","author":"Picca","year":"2018","journal-title":"Mediat. 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